Starting the Conversation with Young Women

Except for skin cancers, breast cancer is the most common cancer in women. However, it can be successfully treated.

Posted on | By Susan G. Komen

Except for skin cancers, breast cancer is the most common cancer in women. However, it can be successfully treated. Screening tests (along with treatment if diagnosed) can find cancer early, when chances for survival are highest.

Risk Factors (General Information)

Over the past 40 years, researchers have identified many factors that increase breast cancer risk and a few factors that lower risk. Some of these factors affect risk a great deal and others by only a small amount. Although we have learned a lot, we still do not understand what causes breast cancer to develop at a certain time in a certain person. It's likely a combination of risk factors (some of which are still unknown). But why a certain combination of factors might cause breast cancer in one person, but not in another, is still unclear. No one has control over whether he/she gets breast cancer. Many risk factors are still unknown and many are simply out of our control (such as getting older or having a family history of breast cancer).

Knowing what factors may increase your risk can help you work with your health care provider to address any concerns you may have and develop a breast cancer screening plan that is right for you. Find out more.

Breast Density (Risk factor of particular interest for young women)
Breast density is a finding noted on a mammogram; breast density cannot be determined by how the breast feels on a clinical exam. Breast density refers to the amount of fat and tissue in the breast as seen on a mammogram. A dense breast has more tissue than fat. Younger women usually have dense breasts. Women with dense breasts have an increased risk of breast cancer although less than five percent of cases of breast cancer in the U.S. are found in women under the age of 40. Unfortunately, we don’t yet know why breast density is related to breast cancer. At this time, there are no specific recommendations on lowering breast cancer risk for women with dense breasts nor are there any special screening tests recommended for women with dense breasts. However, for women with dense breasts, digital mammography may be better than film mammography. If you have any concerns about your breast density, talk to your provider. Learn more.

When to screen for breast cancer
Mammography in women ages 40 to 49 may save lives, but the benefit for younger women may be less than for older women. There are a few reasons why mammography may offer less benefit for younger women than for older women. Younger women tend to have dense breast tissue, which can make abnormal findings hard to see with current mammography technology. Breast cancers in younger women also tend to grow faster than breast cancers in older women. This means mammography every one to two years may be less likely to catch breast cancers in younger women early, when the chances of survival are highest. See here.

Screening Recommendations for Women at Higher Risk
Regular breast cancer screening is important for all women, but even more so for those at higher risk. If you are at higher risk of breast cancer, you may need to be screened earlier and more often than other women. A woman is considered at higher risk if she has one factor that greatly increases her risk or several factors that together increase risk. Your health care provider may use different tools to assess your risk and help you make a personalized breast cancer screening plan. Learn more.

Breast Cancer in Young Women (Under 40)
Breast cancer is rare in younger women. Fewer than five percent of all breast cancers diagnosed in the U.S. occur in women under 40. Even so, if you are a woman in your 20s or 30s, you may worry about your risk of breast cancer now and in the future. 

In general, the risk of breast cancer is low for younger women though. For women 40 or younger, the chance of developing breast cancer over the next 10 years is less than two percent. We don’t know what causes breast cancer to develop in any one woman, no matter her age. However, a few factors are especially important to breast cancer risk in younger women. These include inherited gene mutations and African American ethnicity.

Screening mammograms are not recommended for women younger than 40 who are at average risk of breast cancer. For most women ages 20 to 39, clinical breast exam at least every three years is recommended.  However, for younger women at a higher risk of breast cancer (such as women with a BRCA1 or BRCA2 gene mutation) more intensive screening may be recommended. These women may begin mammography at an earlier age and they may need breast MRI in addition to mammography and clinical breast exams.

Because most young women do not get mammograms, breast cancer is most often first detected when a woman notices a lump or change in the look or feel of her breast, nipple or underarm area. A health care provider may also note a change during a clinical breast exam.

Although most changes in a young woman’s breast are not breast cancer, any change should be reported to a health care provider.

Younger women are more likely than older women to have more advanced stage cancers at diagnosis. Breast cancer treatment for younger women is often effective and survival is usually good. With treatment, most young women can expect to live many years.  Find out more.

Unique Issues for Young Breast Cancer Survivors
A breast cancer diagnosis can be especially shocking and challenging for young women. At a time in life most often reserved for family and career, issues of treatment, recovery and survivorship suddenly take top priority.

However, with treatment the chances of survival for young women diagnosed with early breast cancer are good, but prognosis tends to be worse in women under 40 than in older women. Breast cancers in younger women are more likely to be fast-growing, higher-grade and hormone receptor-negative. Each of these factors makes breast cancer more aggressive.

A main concern for young women being treated for breast cancer is loss of fertility. Chemotherapy can damage the ovaries, and both chemotherapy and tamoxifen can cause irregular periods or stop periods altogether.   There are steps you can take before treatment begins to help preserve your ability to have children. Storing embryos before treatment is one option. Unfertilized eggs can also be frozen and stored. If you wish to have a child after treatment, talk to your health care provider (and if possible, a fertility specialist) before making treatment decisions and discuss your options. Meeting with a fertility specialist as early as possible (before surgery) offers the widest range of options.

The prospects are very good for young women with breast cancer. With treatment, most women can expect to live for many years. Learn more

Co-survivors:
For most young women, their role is more than likely one of a co-survivor, rather than a patient. A co-survivor is a person who lends support to someone diagnosed with breast cancer. They may lend support in big ways or small ways from diagnosis to treatment and beyond.  Co-survivors, whether they are a friend, co-worker, family member or spouse, play an important role.. The social support that co-survivors can provide can reduce anxiety and stress, fatigue and the experience of pain in survivors and improve mood, self- image and the ability to cope with stress. Co-survivors can provide much-needed emotional support by just listening, giving a hug or just being there.  Read more about co-survivors.

Komen Breast Care Helpline:
In addition, we provide a Breast Care Helpline (1-877-465-6636) with caring and compassionate staff who can answer questions about breast health and breast cancer, offer psychosocial support, and provide information about community or financial resources that can help callers deal with concerns or fears about breast cancer or cope with breast cancer issues. Call with specific questions or needs, or if you simply want to talk and need a good listener.

Provided by Ford Warriors in Pink

Article written by Susan G. Komen